By Sarah Fam
AVANT Claims Manager
The digitisation of ophthalmic images has opened up a number of possibilities within eye care such as automated pathology detection as well as electronic storage and transmission.
The ability to take high-quality images on mobile phones has increased the use of images in clinical practice, particularly in hospitals. The development of smartphone applications specifically designed for use in clinical settings has increased, and the use of smartphones as diagnostic tools is dramatically changing both the process of diagnosis and the settings in which optometric diagnosis occurs.1
The introduction of these developments and innovations in technology and their implementation in patient care, raise the questions of how they affect professional responsibilities, and what risks are posed by their use.
The Australian Medical Association and the Medical Indemnity Insurance Association of Australia have jointly produced guidelines entitled Clinical Images and the Use of Personal Mobile Devices: A Guide for Medical Students and Doctors.
These guidelines, while targeted at health professionals working in the public hospital system, are a useful reference for health professionals working in other clinical settings and should be read in conjunction with relevant privacy legislation.
It is important for health professionals making use of current and future technology to be aware of the medico-legal implications of taking images on their mobile phones or other devices. In particular, health professionals need to understand that these images constitute part of the patient’s clinical record and should be afforded the same level of care and attention in respect of storage, security and disposal.
The guidelines address these obligations in order to assist health professionals in understanding their responsibilities when using personal mobile devices to take or transmit images in the course of providing clinical care.
The guidelines define the term ‘clinical image’ as extending to photos, video recordings or audio recordings, which may be of the patient’s body—such as an injury, skin lesion or body fluid—or an image of a pathology report, diagnostic image or medication.
The patient’s informed consent is required prior to taking any images, and they should be taken only when clinically necessary. Practitioners need to ensure the patient understands the purpose of taking the image, its prospective use, and the likely recipients and viewers of the image. The consent process should be well documented in the patient’s clinical file.
As is the case with the sharing of health information generally, practitioners should not share a clinical image without patient consent.2
The guidelines advise that practitioners must take reasonable steps to ensure the security of these clinical images.
Practitioners should make certain that any clinical images stored on personal devices do not automatically upload to social media networks or back-up sites, that they have control measures in place to prevent unauthorised access to the device, and should delete records from the device completely once they are copied to the clinical file.
If optometrists have any doubts about their obligations, they should seek advice from their professional indemnity provider.
- For example, applications including those developed by the University of Cambridge and PEEK (Portable Eye Examination Kit)
- Exceptions to this rule include when you are sending an image in circumstances where the patient would reasonably expect you to do so, and if permitted by law.
Disclaimer: The information in this publication is general information relating to legal and/or clinical issues within Australia (unless otherwise stated). It is not intended to be legal advice and should not be considered as a substitute for obtaining personal legal or other professional advice or proper clinical decision-making having regard to the particular circumstances of the situation. While we endeavour to ensure that documents are as current as possible at the time of preparation, we take no responsibility for matters arising from changed circumstances or information or material which may have become available subsequently. Avant Mutual Group Limited and its subsidiaries will not be liable for any loss or damage, however, caused (including through negligence) that may be directly or indirectly suffered by you or anyone else in connection with the use of information provided in this forum.
Avant provides professional indemnity insurance for members of Optometry Australia